Estimating The Organ Donor Potential in Non-Intensive Care Units in Denmark: A Retrospective Analysis of Potential Organ Donors in The Central Denmark Region.

Abstract

The aim of this study was to assess unexploited organ donor potential consisting of patients dying in non-intensive care units (ICU), of cerebral catastrophes, and without medical contraindications for organ donation. The cohort was identified by the Danish Cause of Death Registry. Data were collected on patients who died within 48 hours from admission, by one of the known etiologies that cause brain death, in non-ICU wards in The Central Denmark Region, from January 2008 till December 2010. Incidence of conditions compatible with imminent brain death was assessed by a medical records review of patients who had had computed tomography scan of the cerebrum (CTC). After retrospectively reviewing a total of 287 medical records, excluding cases not consistent with imminent brain death and with absolute contraindications for donation, the pool of identified possible donors after brain death (DBD) consisted of 87 persons. The mean age was 77.1 years (36-96 years). 71.3% of the deaths were due to cerebral hemorrhage, 21.7% died of subarachnoid hemorrhage, 6.9% of cerebral infarction and 1.1% due to a benign cerebral neoplasm. The main comorbidities of the identified DBDs were hypertension (60%), heart diseases (41%), lung diseases (16%), diabetes (13.8%) and kidney diseases (2.3%). Each case was then evaluated by a transplant coordinator (TC) with respect to medical suitability to organ donation. Of the 87 possible DBDs, the TC identified 9 eligible donors, in 30 cases it was not possible to assess eligibility because of missing information, in 5 cases permission was refused by relatives, and 43 had medical contraindications precluding organ donation. An unexploited DBD donor potential was identified during a 3 year period in a region with population of about 1.3 MIO, of which, in at least 9 cases, neither absolute nor relative medical contraindications were found. However, in those 9 cases, no information on consent was available.